Day 52 - Breakfast & Brunch (15/11/2017)

Early start again - still feeling like the walking dead two from our house made it in for 8am to attend the Dean's Breakfast, an opportunity for students to give feedback to the medical school in person. Sadly even at 8 the parking situation was completely hopeless on Gibbet Hill, meaning a trip to the main campus to find a space and subsequently not making it inside until 20 minutes later.

Quite a few separate concerns were raised by students, but to the credit of WMS they did seem to be genuinely taken on board and the current situation of things explained. It appeared that everyone was willing to speak very candidly if required, which I suppose is at least in part due to the older cohorts of a graduate scheme - people know what things should be up to standard and what is equally less important. I did manage to snaffle a croissant as everyone was leaving, not having dared to cross the very full room while the Dean was speaking.

Headed back to main campus immediately afterwards for a breakfast/brunch meeting with our CBL group - I'm not entirely sure what the distinction is between these two events but that's purely incidental. The venue was Xananas (I'm not sure how to pronounce it either), and the food was cheap as far as on-campus options go - salmon and scrambled eggs with a glass of fruit juice was about £4.50. 9/10 would brunch again.

We then ventured back once more for the final session of this CBL case - I presented some prepared slides on the relevance of acids and bases in the body, focusing on identification of respiratory and metabolic acidosis and alkalosis, as well as the relevance of Base Excess. We ploughed through the investigatory results from the second case, interpreting as best we could - the microbiology section was curiously blank. The chest X-ray indicated fluid in the right lung, leading us to (correctly) diagnose pneumonia, secondary to an upper respiratory tract infection. The patient was currently in sepsis and was at risk of proceeding into septic shock. This meant that not only did the infections have to be dealt with, but he would require intensive short-term management to prevent organ failure. He would also be at increased risk of similar infections in the future.

A similar CXR to the one taken in our patient. The white area indicates presence of fluid.

A similar CXR to the one taken in our patient. The white area indicates presence of fluid.

In the afternoon we had some spirometry labs in the Life Sciences building - these were purely optional, but it seemed like a good opportunity to learn more about the relevant processes. I opted out of being a volunteer for once, as I didn't think my throbbing forehead could tolerate the effort of forced breathing. We were offered a readout of our lung function however, and it turned out I could exhale reasonably well despite being congested. For reference, FEV here is the volume of air exhaled over the first second, while FVC is the volume exhaled during the whole breath. 'Pr' denotes my expected readings based on my height, age and ethnicity.